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Legislative Update
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Congress Considers a Limited Agenda

By James K. Finley
Associate Executive Director and Director of Public Policy

Congress has been in recess for two weeks over Passover and Easter, and it will take up a limited agenda when it returns early this month. Items on its list for consideration include:

  • A very modest tax bill,
  • Charter schools legislation,
  • Oversight of the Obama administration’s response to Russia and Ukraine, and
  • Consideration of the annual appropriations bills for federal agencies, including the Substance Abuse and Mental Health Services Administration (SAMHSA) and all Health and Human Services (HHS) agencies.

AMHCA’s top legislative concern this month will be controversial mental health legislation driven by the House GOP concerning mental health services, funding, and civil rights issues. The legislation, sponsored by Rep. Tim Murphy, PhD, (R–Pa.) a clinical psychologist, is known as Helping Families in Mental Health Crisis Act (HR.3717).

Last month, AMHCA Director-at-Large LaMarr Edgerson, PsyD, LMFT, NBCCH, of New Mexico testified for the profession at a congressional hearing on the broad legislation

Many national mental health groups have major reservations about the proposed legislation, but to date Rep. Murphy has been unwilling to make significant changes. Some observers consider the bill hopelessly stalled, but others believe it may pass the House before dying in the Senate by year’s end. 

Recently, former Rep. Patrick Kennedy (D–R.I.) began working with mental health groups to try and broker a compromise with Rep. Murphy. The legislation was originally written by Rep. Murphy to provide a GOP legislative response to the Newtown ele-mentary school shootings that occurred in December 2012.

National mental health groups are divided over numerous provisions in the bill. AMHCA has expressed concerns about changes in federal health privacy law (HIPAA) and Medicaid funding increases for psychiatric beds rather than expanding outpatient providers and services. AMHCA advocates that rather than embracing the controversial elements of the bill, Congress should pass Medicare provider-status legislation for the clinical mental health counseling profession and expand other community services. In addition, the sweeping legislation would dramatically restructure federal mental health activities at SAMHSA and other HHS agencies. 

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AMHCA is currently working with Democrats on the House Energy and Commerce Committee to draft a more constructive alternative to HR.3717. The Democrats’ draft already contains AMHCA’s Medicare provider-status provision, and they are also considering inclusion of our VA intern legislation, S.1155/HR.3499. 

AMHCA’s strategy is to continue speaking up during the House consideration process for the need to address coverage and provider disparities to meet patient needs before they escalate into psychiatric emergencies.

Medicare Legislation Remains in Play

Last month the House and Senate wrapped up consideration of the annual Medicare “doc fix” legislation. The annual must-pass Medicare legislation is the target vehicle for virtually all Medicare legislative changes each year, leaving AMHCA with few shots at moving our Medicare provider -status legislation (S.562/HR.3662) during the second half of 2014.  Therefore, we are working now to add it to the mix for consideration with the Murphy bill, HR.3717. At this time we anticipate it will be added to the Democratic alternative when it is introduced later this month. 

Unfortunately, the path toward passage of the Murphy bill or an alternative is precarious at best due to the numerous controversies that surround the underlying bill. 

AMHCA will continue to press its Medicare agenda in the debate as it unfolds, and we continue to strongly encourage our members to remind their members of Congress to co-sponsor the legislation. 

Legislation Delays ICD-10 Conversion for at Least One Year—to October 2015 at the Earliest

When President Obama signed hastily passed Medicare legislation on April 1, it included an amendment that delays the implementation of the latest version of the International Classification of Diseases (ICD) codes. The mandatory adoption of the ICD-10 billing codes had been planned for Oct. 1, 2014, but now will not take place until Oct. 1, 2015, at the earliest

The ICD-10 codes are not actually new—they were first released in 1992; however, the United States did not opt to adopt the latest version until now. Once adopted, the nation’s health-care system will completely shift over to ICD-10 codes. These will then be the HIPAA-approved codes required in healthcare and used by insurance companies, Medicare, Medicaid, and other health agencies. 

The amendment to the new law, The Protecting Access to Medicare Act of 2014, was controversial. The delay was urged by some hospital and physician groups, though the American Medical Association feels the delay provides only temporary relief from the bur-den of the ICD-10 conversion.

For more on how the ICD-10 will affect your practice, see the February Advocate article.